An immigration medical exam is a necessary part of immigrating to the United States and becoming a permanent resident (green card holder). Sometimes called a green card medical exam, the appointment is a routine part of the process to ensure public safety and remove the grounds for inadmissibility for intending immigrants.
Certain diseases of public health significance make an individual inadmissible to the United States. The exam is the process to remove these grounds of inadmissibility.
Purpose of an Immigration Medical Exam
The medical grounds of inadmissibility, the medical examination of foreign nationals, and the vaccinations administered to foreign nationals are designed to protect the health of the United States population. The immigration medical examination, the resulting medical examination report, and the vaccination record provide the information U.S. Citizenship and Immigration Services (USCIS) uses to determine if a foreign national meets the health-related standards for admissibility.
Any of these four basic medical conditions may make an applicant inadmissible on health-related grounds:
- Communicable disease of public health significance
- An immigrant’s failure to show proof of required vaccinations
- Physical or mental disorder with associated harmful behavior
- Drug abuse or addiction
Selecting a Doctor for your Exam
You won’t be able to go to any doctor for your immigration medical exam. The examination must be performed by a physician that is approved by the U.S. government. If you are applying for an immigrant visa through a U.S. embassy or consulate (known as consular processing), they will provide a list of panel physicians who have been certified the Department of State. In most cases, you’ll have a choice of physicians. But it’s always best to check with the procedure at your local consulate. You may need to have your appointment notification before the panel physician will see you.
What to Take to your Medical Exam
In preparation for the medical examination, you take the following items:
- Valid passport or other government-issued photo identification
- Vaccination records
- Form I-693, Report of Medical Examination and Vaccination Record (if adjusting status)
- The required fee (varies by doctor)
- Required number of U.S. passport photos (if applying abroad – check with consular office)
- Report of the condition and any special education or supervision requirements (if anyone in your family is immigrating with learning disabilities)
- List of medications (if you are being treated for a chronic medical condition or taking medications on a regular basis)
- Tuberculosis certificate from your doctor (if you’ve had a previous positive skin test for tuberculosis) proving that you were adequately treated
- Certificate of clearance signed by a doctor or public health official, proving that you were adequately treated (if you have had syphilis)
- If you have a history of harmful or violent behavior resulting in injury to people or animals, information that will allow the doctor to determine whether the behavior was related to a psychiatric or medical problem, or to drug or alcohol use
- If you have been treated or hospitalized for psychiatric or mental illness, or alcohol or drug abuse, written certification including the diagnosis, length of treatment, and your prognosis
The doctor will make sure that you have had all the required vaccinations. Some vaccines are expressly required by the Immigration and Nationality Act, and others are required because the Centers for Disease Control and Prevention (CDC) have determined they are in the interest of public health. Regardless, you must receive the following vaccinations before being admitted as a permanent resident:
- Mumps, measles, rubella
- Tetanus and diphtheria toxoids
- Haemophilius influenza type B
- Hepatitis B
- Pneumococcal pneumonia
- Hepatitis A
At the time of publishing this article, the list above is complete. However, new vaccinations may be added to the list over time. Not everyone requires all the vaccinations. USCIS maintains a chart of vaccinations that are considered medically appropriate by age.
If you’ve already been vaccinated, bring your vaccination reports to the doctor. The report will need a certified translation if it is not already in English. If you haven’t been vaccinated, the doctor will administer them. Depending on the type of vaccination, an additional visit may be required.
The doctor or a member of the doctor’s staff will ask questions about your medical history. Of particular interest to the doctor is any time you have ever:
- Stayed at a hospital or experienced significant events in your health history; or
- Been put in an institution for a a chronic physical or mental condition; or
- Been sick or disabled so seriously that it resulted in a “substantial departure from a normal state of well-being or level of functioning.”
The doctor will also ask specific questions about habitual drug use. Applicants who are found to be drug abusers or addicts are inadmissible. Recovering drug addicts who are in remission, however, are admissible. Likewise, if the applicant is classified as a drug abuser or addict, the applicant can apply again for permanent residence if his or her drug abuse or addiction is in remission. If you have an history of drug abuse, even if it’s not in your medical records, consult with an immigration attorney before attending the green card medical exam.
The doctor will then give you a physical examination. Typically, the physical exam includes looking at your eyes, ears, nose and throat, extremities, heart, lungs, abdomen, lymph nodes, skin, and external genitalia. The doctor will also order a chest X-ray and blood test. Children will generally be excused from the X-ray and blood test requirement. If you are pregnant, contact your respective embassy or consular office to inquire about a postponement.
The doctor will even perform a mental status exam that assesses your intelligence, thought, comprehension, judgment, affect, mood, and behavior. Applicants who have physical or mental disorders and harmful behavior associated with those disorders are inadmissible. The inadmissibility ground is divided into two subcategories:
- Current physical or mental disorders, with associated harmful behavior.
- Past physical or mental disorders, with associated harmful behavior that is likely to recur or lead to other harmful behavior.
Cost of Immigration Medical Exam
Costs for immigration medical exams can vary significant based on the country where it will be performed and the specific doctor. Prices can vary from $100 to over $400. The U.S. government doesn’t set a standard fee. The cost will depend on the doctor you visit. Therefore, check with a few doctors to find out how much each one charges for the immigration medical exam.
You may also need to consider the indirect costs of the exam. In some cases, you may need to travel to the interview city early for the purposes of the medical exam.
When the examination is complete, the doctor will prepare a form provided by USCIS with results and findings. In many cases, the doctor will send the results directly to the consulate when you are applying for a visa overseas. If your immigration medical exam is inside the United States, the civil surgeon will give you Form I-693, Report of Medical Examination and Vaccination Record, in a sealed envelope. Do not open the envelope under any circumstance. Submit the medical exam along with Form I-485, Application to Adjust Status. If you have already filed your adjustment of status application, submit the envelope at the USCIS green card interview. The results of your immigration medical exam are generally valid for two years. Specifically, the Form I-693 is valid only when a civil surgeon signs it no more than 60 days before the date an applicant files the application for the underlying immigration benefit; and USCIS adjudicates the application within two years from the date of the civil surgeon’s signature.
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